Individual provider Active NPI

David Ruzicka, DO

  • Emergency Medicine Physician
  • Humboldt, IA
National Provider Identifier
1629069786
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
03221 Issued in IA
Practice address
1010 15TH St N
Humboldt, IA 50548-1008
Phone
(515) 332-2015
NPI assigned
Oct 28, 2005
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 03221 IA Primary

Addresses

Primary practice location

1010 15TH St N
Humboldt, IA 50548-1008

Mailing address

24 N 9TH St
Suite a
Fort Dodge, IA 50501-3905
Phone (515) 574-6890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@pamhn.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000465 IA Practitioner - Family PracticePractitioner - Emergency Medicine 6002724309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palo Alto County HospitalGroup PAC ID 4486563061, 23 clinicians

Practice addresses (Care Compare)

3201 1St St
Emmetsburg, IA 50536-2516
Phone (712) 852-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Holy Family Current Accepting new patients
Palo Alto County Hospital Past Accepting new patients

Locations

826 N 8th St
Estherville, IA 51334
Phone (712) 362-2631

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1629069786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N 9TH ST",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505013905",
            "telephone_number": "515-574-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 15TH ST N",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481008",
            "telephone_number": "515-332-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZICKA",
        "first_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "03221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@pamhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Palo Alto County Health Systems Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccda",
            "address_1": "3201 1st St",
            "city": "Emmetsburg",
            "state": "IA",
            "country_code": "US",
            "postal_code": "505362516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Humboldt, IA

Sources for this page

Verify at the official NPI Registry.